Department of Oral Surgery, Wroclaw Medical University, Poland.
Department of Experimental Dentistry, Wroclaw Medical University, Poland.
Adv Clin Exp Med. 2021 Jun;30(6):575-580. doi: 10.17219/acem/134875.
Masseter muscle pathologies include hypertrophy and the experience of pain, which clinically manifest with increased stiffness and tension. Assessment of muscle stiffness has been gaining importance among physicians dealing with temporomandibular disorders (TMD). Currently, shear wave elastography (SWE) is still often performed by radiologists, while dentists diagnose, treat and monitor TMD.
In this cohort study, we investigated whether dentists trained to use SWE can obtain reliable measurements of masseter muscle stiffness following participation in a short training program and hands-on workshop.
A group of healthy volunteers was examined by an experienced radiologist and a novice dentist before and after the training.
The mean values of stiffness obtained by the operators were consistent and ranged from 10.20 kPa to 10.84 kPa. Intraobserver agreement was excellent for measurements of the radiologist (intraclass correlation coefficient (ICC) 0.92 and 0.93, respectively). The training improved the agreement between measurements made by the dentist from poor before the training (ICC = 0.46) to good after the training (ICC = 0.89). Also, the operator agreement between the radiologist and dentist increased from poor (ICC = 0.48) before the training to good (ICC = 0.84) after the training.
The diagnostic accuracy of measuring masseter muscle stiffness was acceptable among dentists after the training. For this reason, the patient can be diagnosed by a single TMD specialist. This can shorten the diagnostic process and reduce treatment costs.
咀嚼肌疾病包括肥大和疼痛,其临床表现为僵硬和紧张增加。评估肌肉僵硬在处理颞下颌关节紊乱(TMD)的医生中变得越来越重要。目前,剪切波弹性成像(SWE)仍然经常由放射科医生进行,而牙医则进行诊断、治疗和监测 TMD。
在这项队列研究中,我们研究了经过短期培训和实践工作坊培训的牙医是否可以获得可靠的咀嚼肌僵硬测量值。
一组健康志愿者在培训前后由一位经验丰富的放射科医生和一位新手牙医进行检查。
操作者获得的硬度平均值一致,范围为 10.20 kPa 至 10.84 kPa。放射科医生的观察者内一致性非常好(组内相关系数分别为 0.92 和 0.93)。培训提高了牙医在培训前(ICC = 0.46)测量值的一致性,使其从较差变为较好(ICC = 0.89)。此外,放射科医生和牙医之间的操作者一致性也从培训前的较差(ICC = 0.48)提高到培训后的较好(ICC = 0.84)。
经过培训,牙医测量咀嚼肌硬度的诊断准确性可以接受。因此,患者可以由单一的 TMD 专家进行诊断。这可以缩短诊断过程并降低治疗成本。